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What is it like to be an Advanced Nurse Practitioner?

helen adkins

Helen Atkins talks to us about her role as an Advanced Nurse Practitioner and how she supports people living with diabetes. 

I’ve been a nurse since 1982 and I moved into diabetes care in 2000. I have a unique role working as an Advanced Nurse Practitioner (ANP), clinical lead and clinical tutor.

Wearing three hats

My roles mean that I wear three hats: a nurse, clinical lead and clinical tutor.

Within my role as an ANP and as a registered nurse, I have completed extra training and academic qualifications enabling me to examine, assess, make diagnoses, treat, prescribe treatment and refer patients if required to clinicians. I’m also able to discharge patients that are on my caseload.

I currently work for the University Hospitals of Leicester NHS Trust, and I support people living with diabetes across three hospital sites.

In my clinical role, I work with the inpatient team and the hepatobiliary team. I’m the first ANP within the diabetes department for the hospital trust. It’s been challenging embedding the role into practice - no one day is the same and it's more often a mix.

I’m also a clinical tutor for the University of Leicester. The majority of these classes are now online, which has opened the course up to many overseas students. However, I do miss the face-to-face lecturing and the peer support it offered. I believe passionately that as a educator it is vital for me to have clinical experience, and thinking theory into practice.

No day is the same

When I work with the inpatient team, I support them by leading a ward round. The team aims to see people who have diabetes and have been admitted to our emergency floor.

Our aim is to ensure that people with diabetes are treated in a timely and appropriate way and have a shared plan of care. We know that many people with diabetes are admitted to hospitals for many different reasons. Diabetes in the inpatient setting can make something simple turn into a complex situation.  

I assess the person with diabetes and form a diabetes treatment plan most appropriate to their specific needs at that time, and utilise the opportunity to share my expertise and knowledge with my team and other hospital clinicians and healthcare professionals.

I really enjoy talking to people with diabetes, and listening to their stories is so important. It’s shaped who I am today.

I also work with the hepatobiliary team. In this role I still also work as an ANP, working with two multidisciplinary teams. One team provides a clinic for people with chronic pancreatitis – this is when the pancreas can become inflamed for a number of reasons and people need support to manage the condition - and some people can be diagnosed with what's known as type 3c diabetes.

The other team I work with is the Total Pancreatectomy with Islet Auto Transplantation (TPIAT). Islet cell transplantation is a complex surgery that removes the pancreas, and my role is to provide extensive care and support, helping them along their journey adjusting and changing insulin treatments as required. This group of people have usually lived with chronic pancreatitis for a long time.

I would like to think I lead by example to ensure high levels of professional performance and conduct is being delivered.

Supporting change

I also lead a team of diabetes specialist nurses (DSNs), along with administration staff, providing leadership and operational support where needed in the team.

I contribute to the strategic development of the diabetes service and work to ensure objectives are achieved. I also support new ways of working which include changes to services my team provide for patients and the development of the team.

Leading by example

As the clinical nurse lead, I would like to think I lead by example to ensure high levels of professional performance and conduct is being delivered, by making sure all the team fulfil the requirements of their jobs.

I also write and update local policies and guidelines, inform strategic development and monitor our external environment to anticipate changing demands on service provision. Plus I have specific responsibility for leading the development and operation of clinical services.

One example is we have seen that technology has really come to the forefront for people with diabetes. One aspect is remote glucose monitoring. I have developed, with a small team, a virtual ward, with the aim to reduce the length of stay and reduce foot fall across our emergency floor.

Not only has this new service been challenging the use of the technology, but it’s a great tool for our users. One of our users said 'I felt reassured that after my discharge from the hospital it was like you were holding my hand and you were supporting me from the hospital'. It’s these comments that make everything I do worthwhile.


My patients have shaped me as a person. I am so fortunate to also work with a great, inspirational diabetes team.

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